(425) 354-3628
Jessica H. Y. Chen DDS &
Emma K. Etemadi DDS
14142 Main Street NE
Suite 104
Duvall, WA 98019

Our Blog

What is your TMJ? Signs of TMJ Disorder

April 20th, 2018

The temporomandibular joints, called TMJ, are the joints and jaw muscles that make it possible to open and close your mouth. Located on each side of the head, your TMJ work together when you chew, speak or swallow and include muscles and ligaments as well as the jaw bone. They also control the lower jaw (mandible) as it moves forward, backward and side to side.

Each TMJ has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and rotate or glide. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working properly may result in a painful TMJ disorder. In fact, sometimes TMJ disorders will cause pain that makes the person feel as if they have a toothache as referred pain.

Possible causes of TMJ disorders include:

  • arthritis
  • dislocation
  • injury
  • tooth and jaw alignment
  • stress and teeth grinding

Diagnosis is an important step before treatment. Part of the dental examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving. Depending on the diagnosis, the dentist may refer you to a physician or another dentist.

There are several treatments for TMJ disorders. This step-by-step plan from the National Institute of Dental and Craniofacial Research allows you to try simple treatment before moving on to more involved treatment. The NIDCR also recommends a “less is often best” approach in treating TMJ disorders, which includes:

  • eating softer foods
  • avoiding chewing gum and biting your nails
  • modifying the pain with heat packs
  • practicing relaxation techniques to control jaw tension, such as meditation or biofeedback.

If necessary for your symptoms, the following treatments may be advised:

  • exercises to strengthen your jaw muscles
  • medications prescribed by your dentist; for example, muscle relaxants, analgesics, anti-anxiety drugs or anti-inflammatory medications
  • a night guard or bite plate to decrease clenching or grinding of teeth.

In some cases, your dentist may recommend fixing an uneven bite by adjusting or reshaping some teeth. Orthodontic treatment may also be recommended. Your dentist can suggest the most appropriate therapy based on the suspected cause.

Contact Drs. Jessica Chen and Emma Etemadi at Duvall Family Dental for your dental check up! We are your dental home in Duvall, Washington.


Information from American Dental Association

Erosion Risk Management- What to do at home

April 13th, 2018

Erosion Risk Management

  • Reduce acid exposure by reducing the frequency and contact of acids.
  • Chewable and effervescent formulations should be avoided, especially when experiencing drug-induced xerostomia.
  • Acidic mouthwashes should be avoided, especially by individuals with hyposalivation. Do not hold or swish acidic drinks in your mouth. Avoid sipping these drinks.
  • A spacer device should be used to deliver inhaled drugs directly to the airway.
  • Consider using modi ed acid (calcium forti ed) beverages with no or reduced acid potential.
  • Acidic liquid medications should not be sipped, held in the mouth, or swished in the mouth. When possible, tablets should be chosen over liquid medications.
  • Avoid toothbrushing immediately after severe erosive challenge (vomiting). Instead, use an antacid tablet (best), a sodium bicarbonate (baking soda) solution, a uoride-containing mouth rinse (maintenance rinse), milk or food, such as cheese or sugar-free yogurt. If none of the above is possible, rinse with water. One study observed that stannous uoride was optimally applied before the erosive challenge whereas sodium uoride after to prevent erosion of the teeth. Use a soft toothbrush and low-abrasion uoride-containing toothpaste. High abrasive toothpastes may remove the pellicle (which is protective).
  • Tooth surfaces can be made resistant to acid impact either by applying dentin adhesive or uoride or by using amorphous calcium phosphate-casein phosphopeptide or nano-partical hydroxyapatite.
  • Consider Remineralization Strategy:
    • –  Complex of casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) which delivers supercharged Ca and PO4 ions to the enamel. Over eighty studies to date have shown the e ectiveness of RECALDENT (CPP-ACP) in remineralizing enamel and preventing and reversing early (non-cavitated) carious lesions.
    • –  CTx4 Gel 5000 contains xylitol and optimal levels of nano-partical hydroxyapatite at an elevated pH to neutralize acids and promote remineralization.
  • After acid intake, stimulate saliva flow with chewing gum or lozenges.
  • Use chewing gum to reduce postprandial reflux.
  • Drink water frequently to counteract dry mouth.
  • Refer patients or advise them to seek appropriate medical attention (gastroenterologist and/or psychologist) when intrinsic causes of erosion are involved.
  • Recommend regular dental check-ups and educate patients taking medications that can induce erosion directly or indirectly about their susceptibility to oral health problems. Note that manufacturers can modify formulations by increasing the calcium, phosphate, and mineral content in the medication and, if possible, use formulations with low titratable acidity as substitutes.

Information from 2017 Kois Center, LLC

Acid, Sugar, Quantity and Timing- how to avoid melting teeth

April 6th, 2018

Acid, Sugar, Quantity and Timing- how to avoid melting teeth


Soft drinks, sports drinks, energy drinks and juices pack a double dose of acid and sugar that may destroy teeth. Acid softens enamel and chemically dissolves the outer layer. This is dental erosion. Softer enamel is more sus- ceptible to decay.


Sugar feeds the bacteria, which cause tooth decay. Drinks are liquid candy, which easily pools between and around the teeth. This promotes bacterial growth and decay.


Super sizing a drink increases the contact time and causes more damage. Sipping small amounts over time leads to cumulative destruction. The longer it takes to drink a sugar laden, acidic drink, the greater the damage.


Sports and energy drinks have more acid than soft drinks. When one is dehydrated with no saliva, the acid in the sports and energy drinks dissolves enamel more quickly. Sipping a sugary, acidic drink all day while driving, study- ing or working dissolves enamel and promotes cavities.


• Drink in moderation.
• Use a straw.
• Drink at one sitting or with food.
• Drink water to rehydrate.
• Wait one hour to brush after an acidic drink.
• Use fluoride and remineralizing products.
• Drink milk. Its neutral pH of 6.7 and 1 tsp of lactose (sugar) per 12 ounces are healthy for teeth.

Sugar and Acidity or pH of common drinks

Please note: Battery acid is listed below only for purposes of comparison, and should never be confused for any reason as a beverage.

The pH scale measures the acidity or alkalinity of a solution with pure water in the middle at neutral pH 7. The lower the pH, the stronger the acid.

Drink or Substance (12 oz. serving) Acid pH Tsp. Sugar
Water 7.0 (neutral) 0
Milk 6.7 1
Barq’s Root Beer 4 11
Minute Maid® Orange Juice 3.8 9
Propel® Fitness Water 3.4 1
Red Bull® Energy Drink 3.3 10
Sprite® 3.3 10
Mountain Dew 3.3 12
Diet Coke 3.1 0
Sierra Mist 3.1 10
Full Throttle Energy Drink 3 11
Diet Pepsi 3 0
Gatorade® 2.9 5
Sunkist® Orange Soda 2.9 13
Dr. Pepper 2.9 10
Vault™ Energy Soda 2.9 12
Mountain Dew AMP1 2.8 11
SoBe Energy Citrus 2.6 12
Minute Maid® Lemonade 2.6 10
Pepsi 2.5 11
Diet Schweppes Tonic Water 2.5 0
Coca-Cola Classic2 2.4 10
Battery Acid3 1 0


Call or email Duvall Family Dental to make an appointment with Drs. Jessica Chen or Emma Etemadi for your next dental check-up.


1 Now called AMP Energy. 2 In some geographical areas of the U.S. and Canada known simply as “Coca-Cola.” 3 Battery Acid is NOT a drink.

Test by Dr. John Ruby, University of Alabama, Birmingham School of Dentistry, 2007. Minnesota Dental Association: Sip All Day, Get Decay.

Why do Olympic Athletes Bite their Gold Medals?

February 16th, 2018


Olympic athletes have a habit of biting their medals on the podium, but nobody really knows why. In fact, it's such an enduring mystery that even Olympic historians don't understand it.

There’s actually a few reasons, but the most obvious is that it’s a pose photographers really, really like to capture.

“It’s become an obsession with the photographers,” David Wallechinsky, the president of the International Society of Olympic Historians and co-author of “The Complete Book of the Olympics” told CNN in 2012. “I think they look at it as an iconic shot, as something that you can probably sell. I don’t think it’s something the athletes would probably do on their own.”

Biting down on a hunk of metal is more likely something someone might have done during the Gold Rush to test whether the shiny golden rock they just panned for was actually pyrite or fool’s gold. Human teeth are harder than gold but softer than pyrite, according to the Mohs Hardness Scale, which categorizes how easily minerals scratch. This means a quick gnaw to real gold would actually leave an indentation. A hard chew of pyrite, meanwhile, might damage your teeth.

The practice also once served to see whether coins were solid gold or just gold-plated over a cheaper metal.

With that in mind, it’s likely that Old West/pirate lore led to someone once biting their Olympic medal in a spontaneous, “Is this real life?” moment, and the photographers thought it was cute. Because if someone really was hoping to discover whether that gold medal is pure gold, their smiles would quickly fade.

Olympic gold medals are actually just 1.34 percent gold. The rest is sterling silver. They haven’t been made of solid gold since 1912.

*adapted from The Washington Post

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